Downloads and intake paperwork

Please complete intake paperwork prior to your first session. You may bring it with you in paper form or email to address on forms.  All forms are in PDF format.

Agreement To Pay For Professional Services

Authorization For Release

Confidentiality Overview Including HIPAA

Consent to Treat Form

Information Form

Miller, Jennifer - Client Intake Form

Office Policies & CC Authorization

Self-pay Sliding Scale

Referral Form